Unfiled Case Report
Bronte Lim, 2T5 WB
Artist’s Statement: I find a lot of comfort and inspiration in that case reports, as much as they are filled with questions to answer and acronyms to go through, there is also a surprisingly rich space for portraiture, impression, and connection.
ID: Ms. M is a 22-year-old university student.
CC: Ms. M arrived at the clinic late on a weeknight with complaint of a sharp pain radiating from the left side of her chest.
HPI: Pain is persistent and radiating, short-lived in duration but regular in occurrence, a 4 on a scale of 0 to 10, originating from a spatial displacement (a geographical dis-ordering) 2 months prior. Pain is aggravated by photos of home, the smell of dark soy sauce hitting a hot wok, and that sickening feeling of finding joy but realizing that that joy is being experienced in the absence of the ones more beloved. Pain is alleviated by warm baths and the background noise created by the next-door couple arguing, making amends, and preparing for slumber, which Ms. M describes as, “Simply lovely.”
PMHx: Ms. M insists I refer to her student medical records, which record up-to-date vaccinations and read only with an additional note of, “No known history.” Ms. M added that she has, since matriculating, developed mild lactose intolerance, which she noticed after experiencing nausea after having ice cream on a lousy date organized by her best friend, N.
FMHx: Ms. M is unsure if her condition is hereditary, but strongly suspects that it is. “Risk factors, shared behaviours. Immigrating then immigrating some more. I did it before I even realized, moving three time zones out—for school I thought, simply for school. Then they went and moved again.” Past family diagnoses are unavailable due to issues with translation, the limiting sizes of suitcases, the prices of international phone calls, and the lack of electronic medical records spanning the family’s decades of departures. No siblings. Both parents are living, 55 and 56, recently retired and recently relocated from Ms. M’s hometown back to their own hometown 2 months ago, 12 time zones away.
Nb. I asked Ms. M to clarify the locations she referred to. She appeared confused at my question and provided no clear reply.
SHx: Ms. M is a non-smoker and drinks socially, 2-3 standard drinks per weekend. She prefers hard liquor, Chinese baijiu, and brings her own to parties.
Medications: Ms. M explains she self-medicates on 3 cups of coffee per day, a cognitive analgesic (Tik Tok), and an OTC sleep aid most weeknights.
Nb. Ms. M asked me to note that baijiu has a bad reputation, but that I (and the health team) should check our biases, especially considering how popular Japanese sake and Korean soju are these days.
ROS: N/A
Nb. Ms. M responded to each question of the typical functional inquiry with, “Why?”
Summary: Ms. M is a 22-year-old woman experiencing pain in the left side of her chest. She does not seem to be in distress and has the close friendship of N, who picked Ms. M up from the clinic. Ms. M may be struggling with a lack of family support. She appeared distracted towards the end of the appointment and suggested that the interview with a medical student might very well be enough; that her problems were not psychosomatic, and that I ought not write that down anywhere; that she thinks a long phone call may be the best course of action. Ms. M states that 22 is a difficult age to be, neither here nor there, made all the more difficult by an indeterminate future and an obscured past.
Nb. When I inquired further about Ms. M’s feelings, she replied that the details were not relevant to my education as a medical student, but possibly relevant to my edification as an individual, also 22.
Impression: Ms. M and N left, arms linked, from the university student clinic. Watching them leave hurt my eyes; the icy wind of late autumn made them water. I find myself thinking about this exchange, hours later, though I should have already submitted this case report to my preceptor. Checking my watch now, it’s possible that Ms. M will call her parents soon because now–and twelve time zones from now–the two halves of her family may be experiencing a similar painful tug on the left sides of their chests.
